CRT

I wasted 10 months being on beta blocker plus valsartan at time diagnosed with non-ischemic left bundle branch block. The hope was to manage the LBBB even though the only symptoms initially were shortness of breath upon exertion. My ejection fraction remains at 40-45 percent.  There is a ton of medical opinions that say medication does nothing for LBBB. In fact, we had to discontinue the beta blocker but kept on the valsartan.  Heart was monitored with a zio patch after ten months on medication.  Report showed three pauses between 3-6 seconds in two week span. I had no symptoms of those pauses, the longest pause happened while sleeping. My electrophysiologist said the report (and last EKG) showed two "wires" in my heart aren't working and one "wire" only works intermittent.  My question:  What would he be referring to as "wires" in the heart's anatomy does someone know?  I understand it to be a signal node conduction problem. He has recommended the CRT-P over the CRT-D.  No specific reason given, so I would ask does anyone have any opinion or experience similar to mine?  I'm a 67 year old female, healthy otherwise and no co-morbidities. 

 

Mayo Clinic reports the average five year survival rate after CRT-P pacemaker is 8.3 years. Is that true, does that sound right?  I know there are pros and cons of this procedure, i.e., lead failure, position issues, battery malfunction, infection, etc...

I appreciate your help.  


5 Comments

CRT

by Tracey_E - 2024-03-19 17:26:57

Have you had another zio since you've been off the beta blockers to see if you still have the pauses?

I suspect he's talking about your heart's natural wiring system, not literal wires. 

The Mayo Clinic report isn't really helpful for us, IMO. You have to know what the average age and health is of the person getting the CRT. My guess is older and less healthy than you, which means that average doesn't apply to you. I will have been paced 30 years in May. The average person doesn't get a pacer at 27 like I did so if anything I'm blowing the curve on a study like that. I've always been told that being paced will not shorten my life expectancy, it is the same as someone with the same overall health as me, minus the heart block. 

Pro's of having it far outweight the con's. Lead failure and position issues can be fixed. Infection can be treated and is rare. Battery malfunction is virutally unheard of. Keep in mind reading posts here that many come here looking for answers for their rare problems. The vast majority of people get their device, heal, and don't have a reason to look for a site like this. Overall complication rate is well under 1%. 

Have you had a second opinion? Your EF is borderline, esp if you are asymptomatic, and your pauses are borderline. That said, if your rate isn't going up appropriately on exertion then the pacer will help you feel better with exercise. And the CRT can help synchronize the left and right ventricles which can, in turn, bring up EF. Mark those in the PRO column. 

D is for defibrillator. EF would have to be a whole lot lower than yours before they recommend that. As long as you aren't at risk of the heart stopping due to very low EF, or going into a dangerous arrhythmia, CRT-D isn't necessary. 

CRT's

by Grateful Heart - 2024-03-21 01:23:23

I just had this conversation with a very close friend of ours.  He had a pacemaker implanted recently as an emergency and afterward the nurse told him he had about 8 years to live.  Understandably, he and his wife were very upset and we've had some important conversations since.        

I am the same age as you.  When I was 50 years old, I was diagnosed with Cardiomyopathy, LBBB, Sick Sinus Syndrome, enlarged heart.   My EF was 24%.  The cardiologist I had at the time tried medication for 3 or 4 months and then I was told I needed a device. 

I have a CRT-D and after about 6 months my EF went to 50% and then 55% by the end of the first year.  

I agree with Tracey, I got a second opinion to confirm I needed a device.  It will also ease your mind and confirm for yourself if you need one.  I didn't know anyone who had a device and I didn't know about this site so I started to research on the computer and I read that I had a 5 year survival rate.  That was 16 years ago! 

Grateful Heart 

CRT

by Terry - 2024-03-26 16:05:00

If you have Microsoft Chrom and access to Copilot (in the upper right corner) ask "Which is safer, CRT or conduction system pacing for LBB?"

CRT

by Terry - 2024-03-26 16:12:58

There's more at www.His-pacing.org

CRT

by Meemaw - 2024-03-29 20:41:53

Tracey, no I haven't done a second patch monitor but will request that at my next appointment.  Thank you for all your insight !  What concerns me too is the meds that the cardiologist will want me to start after CRT.  If they didn't make an improvement in EF all of last year, how will they benefit after pacemaker?  

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I'm 43 and have had my pacemaker four weeks today. I'm looking forward to living another 50 years and this marvelous device inside me will help me do that.